Recombinant growth hormone treatment, osteoporosis and fractures, more complicated than it seems!

Lipoteichoic Acid Rescued Age-Related Bone Loss by Enhancing Neuroendocrine and Growth Hormone Secretion Through TLR2/COX2/PGE2 Signalling Pathway

The phenomenon of brain-bone crosstalk pertains to the intricate interaction and communication pathways between the central nervous system and the skeletal system. Disruption in brain-bone crosstalk, particularly in disorders such as osteoporosis, can result in skeletal irregularities. Consequently, investigating and comprehending this communication network holds paramount importance in the realm of bone disease prevention and management. In this study, we found that Staphylococcus aureus lipoteichoic acid promoted the conversion of arachidonic acid to PGE2 by interacting with TLR2 receptors acting on the surface of microglial cells in the pituitary gland, leading to the upregulation of COX-2 expression. Subsequently, PGE2 bound to the EP4 receptor of growth hormone-secreting cells and activated the intracellular CREB signalling pathway, promoting GH secretion and ameliorating age-related bone loss.

The impact of plant-based diets on female bone mineral density: Evidence based on seventeen studies

BACKGROUND

An increase in awareness of plant-based diets has brought forth numerous studies on bone mineral density (BMD). The present systematic review and meta-analysis was designed to compare the effect between plant-based diets and omnivores on female BMD.

METHODS

We searched the Cochrane Library, PubMed, EMBASE, and Web of Science and up to July 1, 2020. Mean difference (MD) with its 95% confidence interval (CI) was estimated to compare the outcomes of the groups. We compared BMD at the lumbar spine, femoral neck and whole body respectively between plant-based diets and omnivores. In addition, we performed subgroup analyses according to different clinical characteristics for further exploration. Two reviewers assessed trial quality and extracted data independently. All statistical analyses were performed using standard statistical procedures provided in Review Manager 5.2.

RESULTS

A total of 17 cross-sectional studies including 13,888 patients were identified for the present meta-analysis. Our pooled result indicated that population with plant-based diets had lower BMD than omnivores at the lumbar spine (MD -0.03; 95% CI -0.04 to -0.02; P < .0001), femoral neck (MD -0.04; 95% CI -0.05 to -0.03; P < .00001) and whole body (MD -0.04; 95% CI -0.06 to -0.01; P = .01), respectively. Further exploration indicated that especially females with plant-based diets experienced significantly lower BMD at lumbar spine (MD -0.03; 95% CI -0.04 to -0.02; 3173 pts), femoral neck (MD -0.04; 95% CI -0.05 to -0.03; 10,656 pts) and whole body (MD -0.05; 95% CI -0.10 to -0.00; P = .04). In addition, we performed subgroup analyses and found lower BMD at lumbar spine and femoral neck in both vegetarians and vegans.

CONCLUSIONS

The present meta-analysis indicated that plant-based diets may be correlated with lower BMD of women when compared with omnivore population. However, this does not diminish the fact that a plant-based diet can be a harmful option to the overall bone health of population and more prospective researches are needed to clear the impact of plant-based diets on bone health.

Comparison of human bone mineral densities in subjects on plant-based and omnivorous diets: a systematic review and meta-analysis

BACKGROUND

The increased consumption of plant-based diets has encouraged studies of bone mineral density (BMD). The present systematic review and meta-analysis compared the effects of plant-based and omnivorous diets on BMD.

METHODS

We searched the Cochrane Library, PubMed, EMBASE, and the Web of Science to July 1, 2020. We used the mean differences (MDs) with 95% CIs to compare group outcomes. We compared the lumbar spine, femoral neck, and whole-body BMDs of those on plant-based and omnivorous diets. We performed subgroup analyses by various clinical characteristics. Two reviewers independently assessed trial quality and extracted data. All statistical analyses were performed using Review Manager version 5.2.

RESULTS

A total of 17 cross-sectional studies including 13,888 patients were identified. The pooled results indicated that those on plant-based diets (compared to omnivores) exhibited lower BMDs at the lumbar spine (MD - 0.04; 95% CI - 0.06 to - 0.02; P < 0.0001) and femoral neck (MD - 0.04; 95% CI - 0.05 to - 0.02; P < 0.00001), and a reduced whole-body BMD (MD - 0.03; 95% CI - 0.06 to - 0.01; P = 0.0009). Both vegetarians and vegans exhibited lower lumbar spine, femoral neck, and whole-body BMDs than omnivores.

CONCLUSIONS

Plant-based diets were associated with lower BMDs than those of an omnivore population. Plant-based diets may compromise overall bone health; prospective research is required.

Association between Visceral Fat and Bone Mineral Density in Both Male and Female Patients with Adult Growth Hormone Deficiency

Aim

Adult growth hormone deficiency (AGHD) is associated with an increased risk of fractures. The interactions between various body composition and bone are known to be complex in nature. However, very few studies have examined this crosstalk in AGHD. In this study, we sought to investigate the relationship between various parameters of body composition and bone mineral density (BMD) as well as determine the role of visceral fat in determining the bone mass in patients with AGHD.

Methods

We conducted a cross-sectional study on 57 patients with AGHD. Anthropometry, biochemistry, and analysis of body composition and BMD were performed according to standard protocols. Male and female patients were classified into those with osteoporosis and those without osteoporosis (normal subjects and patients with osteopenia). Further, we analyzed the correlation between the BMD and measurements obtained for various body composition parameters in male and female AGHD patients.

Results

Our findings indicated that among female AGHD patients, those with osteoporosis had a significantly higher levels of fat mass (FM) and visceral adipose tissue mass (VATM) (both, P < 0.05) than those without osteoporosis. Further, Pearson correlation analysis showed that the values of age, body mass index (BMI), FM, and VATM correlated negatively with BMD in women with AGHD (all P < 0.05); however, this association was not noted in men. After adjusting for the other covariates, VATM was found to be independently correlated with the BMD in female patients with AGHD.

Conclusions

A close correlation was noted between VATM and BMD in female patients with AGHD.